Infant mental health starts before birth

Karen Bateson explains how our Baby Steps service can support parental and infant mental health

Parent changing babies clothesMental health begins before birth. Who we are, how we respond to life’s ups and downs, and how able we are to develop our potential are all influenced to some degree by our parents’ emotions and relationships. 

Pregnancy gives parents a window of time to reflect and prepare. It’s a time of psychological transition, when hope and optimism collide with anxiety and change. Adults begin to think about who they’ll become as parents and about how their child will respond to them. Relationships with partners, families of origin and the future child come into sharp focus. Many parents-to-be find pregnancy to be a time of change and some parents face additional challenges such as poverty, social isolation, mental health difficulties, substance abuse, or conflict and coercion in relationships. 

In this blog I’m describing how Baby Steps supports parents before and after birth to promote healthy relationships.

Learning from Baby Steps

Research commissioned by the Department of Health in 2009 showed that traditional antenatal education tended not to reach the most vulnerable families and took a medicalised approach with little focus on relationships. At the NSPCC, we want to support parents before difficulties start so that we can prevent child abuse and neglect. So in 2011 we developed Baby Steps, a highly supportive perinatal group which could also address the needs of families who require that bit of extra support.

Baby Steps facilitators go out of their way to engage mums and their partners in a supportive group which focusses on the parent-infant relationship, the couple relationship and parental mental and physical wellbeing. Baby Steps also includes all the typical preparation for labour, birth and beyond. The course has 6 antenatal group sessions and 3 postnatal group sessions, with a couple of home visits at key points.

We successfully piloted and evaluated Baby Steps in 9 areas across the country and listened to feedback from mums and dads. We’re now working with partners in the public and voluntary sectors, supporting them to implement the service in their local areas. Each group is run by qualified health professionals, usually a midwife or health visitor; and a social care colleague, often a family worker from a local service such as a Children’s Centre. They tell us that they love working in this multi-disciplinary fashion and that it’s helpful to share skills, perspectives and better understand one another’s role and organisation. I love the fact that the facilitators demonstrate how 2 different people can work well together – it’s not dissimilar to how parents have to work together to raise their baby.

We’ve learned a lot from delivering, developing and evaluating the programme. But if I had to choose 5 key points, these would be:

    1. infant mental health starts before birth
    2. pregnancy is a great window of opportunity to promote the importance of relationships
    3. parents need integrated support before and after the birth of their child
    4. parents facing additional challenges benefit most from this integrated and supportive intervention
    5. Baby Steps is a unique and innovative programme which has proven outcomes.

To find out more about our findings from the service, have a look at our evaluation.

How Baby Steps improves mental health

What’s most lovely about Baby Steps is the connections that are forged - not just between parents and their new babies, but amongst group members and with the facilitators. Some of the families we work with were really isolated before, so it’s lovely to hear how supportive they are of each other now. Sometimes group members are the first people a new parent will text to say the baby has arrived and many of our parents are still in touch with each other many months after the birth. You can’t buy that level of social connectedness.

We now know that social bonds affect how a child’s brain develops and are an important factor in that elusive concept, happiness. Attunement and reflective functioning, 2 critical factors that help a parent and their child connect with each other, are weaved in to everything we do in Baby Steps. So it’s lovely to see parents come back for the postnatal sessions with their new baby, putting into practice what we’ve taught them about how to relate to babies.

This type of perinatal group, highly supportive, focussed on relationships, weaving key health messages in with practical content about pregnancy, birth and child rearing, has to be the future of antenatal support. It sets the scene for good child mental health and better parental mental health too. Having a baby can be a tough transition, but we’re pleased to be contributing to the positive mental health of generations to come.

Interested in implementing Baby Steps in your local area?

We're now working with partners in the public and voluntary sectors, supporting them to implement this service in their local areas.

Get in touch if you're interested in running this service where you are.

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  1. Schrader McMillan, A., Barlow, J. and Redshaw, M. (2009) Birth and beyond: a review of the evidence about antenatal education (PDF). [London]: [Department of Health].